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Virtual Reality (VR) technologies have become a popular area of study in recent years. These technologies were found to be effective in various useful applications to support People with Disabilities (PWD). The present article explores the current trends addressing the role and applications of VR in supporting individuals with disabilities. It presents the advantages of VR, and how they can be used as assistive technologies to minimize the effects of disabilities and increase the independency of PWD. It also explores a range of successful VR applications for PWD and an example of an assistive VR application in Mada center to support people with disabilities.

Different screening strategies for developmental dysplasia of the hip (DDH) exist. Despite screening efforts, cases of late presentation continue to occur, often necessitating surgery. This systematic review and meta-analysis assess the effect of newborn selective ultrasound screening for DDH on the incidence of late presentation in infants and children, compared to a universal ultrasound strategy. A systematic search across Medline and EMBASE databases was performed between January 1950 and February 2021. A consensus-based evaluation of abstracts led to retrieval of relevant full text, original articles or systematic reviews in English only. These were assessed according to agreed eligibility criteria, and their reference lists were reviewed to identify additional eligible publications. Following final consensus on included publications, data was extracted, analysed and reported as per PRISMA and Prospero (CRD42021241957) guidelines. The 16 eligible studies consisted of 2 randomised controlled trials and 14 cohort studies, published between 1989 and 2014, with a total of 511,403 participants. In total, 121,470 (23.8%) received a neonatal hip ultrasound, of whom 58,086 and 63,384 were part of a selective or a universal ultrasound screening strategy, respectively. The difference in the proportion of late presentation between the universal and selective strategies was 0.0904 per 1,000 (P = 0.047). The time effect, i.e. the difference between early and late presentation defined respectively, as less than and more than 3 months of age, regardless of screening strategy, was not significant (P = 0.272). Although there was variability in study design and reporting, the quality of the evidence, based on the critical appraisal skills programme appraisal tools, was generally good. Compared to universal ultrasound screening for DDH, selective screening resulted in a slightly higher rate of late presentation. Uniformity in design and reporting of DDH studies and a cost-effectiveness analysis are needed.

Aim: This retrospective study’s objective was to evaluate osteoarticular infection in infants less than 12 months of age, with a particular focus on biological features and bacteriological etiology. Material & methods: We retrospectively reviewed the medical records of every infant younger than 12 months old admitted in our institution for a suspected osteoarticular infection between January 1980 and December 2016. Results: Sixty-nine patients records were reviewed, including eight neonates, 16 infants from 1 to 5 months old, and 45 from 6 to 12 months old. Conclusion: Neonates and infants aged from 6 to 12 months old were more exposed to infections. Staphylococcus aureus remained the main pathogen in children

Background: Children with biliary atresia rapidly develop liver fibrosis secondary to inflammatory destruction of the biliary tract. Noninvasive detection of liver fibrosis in neonatal/infantile cholestasis is an additional criterion for the diagnosis of biliary atresia, leading to prompt surgical exploration. Objective: To assess the value of US with acoustic radiation force impulse (ARFI) elastography to detect biliary atresia in the workup of neonatal/infantile cholestasis. Materials and methods: In this retrospective study, 20 children with cholestasis suspected of having biliary atresia were investigated by US and ARFI. We evaluated the association between US findings and the diagnosis of biliary atresia and with two scores of liver fibrosis obtained from liver biopsy. Results: In univariate analyses, gallbladder size, triangular cord sign, spleen size and ARFI values were found to be associated with biliary atresia, though only the triangular cord sign remained significant when elevated gamma glutamyltransferase (GGT) was included as a predictor. In contrast, spleen size and ARFI correlated with the degree of liver fibrosis on biopsy (r > 0.70, P

Interactive Adaptive Systems (IAS) refer to interactive systems that alter their characteristics automatically according to the user’s needs. The IAS have emerged in several application domains and, accordingly, a high level of quality must be assured during their development. However, evaluating IAS still presents different challenges, as there are a set of unique characteristics that can impact the quality of such systems. Moreover, there does not exist a specific study to guide the assessment of IAS considering their main challenges based on an international standard. The main objective of this research concerns the proposition of an evaluation model suitable to the context of interactive adaptive systems, based on ISO/IEC 25040 standard. In the case study, an adaptive hypermedia system is evaluated following the evaluation process restructured from ISO/IEC 25040, with a focus on the first three activities of this process.

International audience; Thanks to the digital revolution, virtual reality (VR) has getting popularity due to its capacity to immerse users into virtual environments (VEs). VEs are typically limited to visual and auditory cues; however, recent results show that multiple sensory modalities increase the user’s immersion. In this study, an experimental protocol is proposed to recreate multiple tactile, in particular thermal, sensations in VR. The aim is twofold:(1) studying the performance of different devices for creating warm and cold sensations with regards to their efficiency and acoustic disturbance; and (2) investigating the interdependency between visual and tactile stimuli in the perception of temperature. 14 participants performed two experimental studies. Our results show no acoustic disturbance of the materials used. Spot projector is more efficient than fan heater to create a warm sensation; fan+ water spray is more efficient than fan alone to create cold sensation. Moreover, no significant contribution of visual cue on the thermal perception was found except for the extremely cold simulation (snow visualization and thermal stimulation performed with fan+ water spray).

This study aimed to evaluate the intra-rater reliability and validity in comparison with the two-dimensional radiography (XR) of inclinometer (INCL) and rasterstereography (RAST) for assessing spinal sagittal angles of AIS patients. Fifty-one AIS patients (13.5 (2.0) years, girls = 32 (63%), Cobb angle = 23.0 (17.4)°) were included in this study. Three repeated measurements of thoracic kyphosis (TK) and lumbar lordosis (LL) were evaluated using the INCL and RAST by the same operator on the same day of the XR examination. Intraclass correlation coefficients (ICC) were used to evaluate the reliability of the INCL and RAST systems. Additionally, Pearson coefficients were computed between the XR and INCL systems and between the XR and RAST systems. Reliability of each radiation-free system was excellent (ICC > 0.75 for INCL and RAST) for both the TK and LL parameters. The Pearson coefficients between each of the radiation-free systems and the XR were high to moderate for the TK (0.50

The choice of suitable evaluation methods for the layered evaluation of Interactive Adaptive Systems (IAS) needs the consideration of different factors, leading to a multi-criteria decision analysis problem. This paper proposes the first step toward a Web-based Multi-Criteria Decision Support System (MCDSS). Our proposal is based on a recent multi-criteria decision method called ELECTRE TRI-B-H (Elimination and Choice Translating Reality) to guide the layered evaluation of IAS. The goal is to support the choice of appropriate evaluation methods for individual layers taking into account constraints of the layered evaluation and the individual layers. The appropriateness of each evaluation method is analyzed for the layered evaluation in general and each layer in particular. The use of ELECTRE TRI-B-H method allows decomposing a decision problem into intermediate sub-problems through a hierarchy model and sorting alternative evaluation methods at different levels of the hierarchy. A case study of an adaptive hypermedia system is presented; in this study, the ELECTRE TRI-B-H method has been applied to select the most suitable evaluation methods for each of its layers taking into account the layered evaluation context. The promising results show the feasibility of the proposed approach, leading to various research perspectives.

Cybersickness (CS) is an affliction that limits the use of virtual reality (VR) applications. For decades, the measurement of cybersickness has presented one of the most challenges that have aroused the interest of VR research community. Having strong effects on users’ health, cybersickness causes several symptoms relating to different factors. In most cases, the literature studies for VR cybersickness evaluation adopt the questionnaire-based approaches. Some studies have focused on physiological and postural instability-based approaches, while others support the VR content. Despite the attention paid to define measurements for assessing cybersickness, there is still a need for a more complete evaluation model that allows measuring cybersickness in real time. This paper defines a conceptual model that integrates subjective and objective evaluation of CS in real time. The proposed model considers three CS factors (i.e. individual, software and hardware). The aim is to consider the heterogeneous findings (subjective and objective measures) related to the selected CS factors that define integrated indicators. The theoretical part of the model was initially validated by researchers who have comprehensive knowledge and skills in VR domain. As a research perspective, we intend to evaluate the proposed model through a practical case study.

OBJECTIVES: In this study, we aimed to contrast the bacteriologic epidemiology of osteoarticular infections (OAIs) between 2 patient groups in successive 10-year periods, before and after the extensive use of nucleic acid amplification assays in the diagnostic process. METHODS: Epidemiologic data and bacteriologic etiologies of all children presenting with OAIs on admission to our institution over 20 years (1997–2016) were assessed retrospectively. The population was divided into 2 cohorts, using the standardized use of polymerase chain reaction as the cutoff point (2007). The conventional cohort included children with OAIs mainly investigated by using classic cultures, whereas the molecular cohort referred to patients also investigated by using molecular assays. RESULTS: Kingella kingae was the most frequently isolated pathogen, responsible for 51% of OAIs, whereas other classic pathogens were responsible for 39.7% of cases in the molecular cohort. A statistically significant increase in the mean incidence of OAIs was observed, as was a decrease in the mean age at diagnosis after 2007. After 2007, the pathogen remained unidentified in 21.6% of OAIs in our pediatric population. CONCLUSIONS: Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between 6 and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriologic etiology of OAIs.

The accurate diagnosis of spondylolysis is widely made with CT scan considered as the gold standard. However, CT represents significant radiation exposure particularly substantial in a young and sometimes still growing population. Although the role of MRI in identifying edema/inflammation within the pars as an active lesion is proved, its ability to demonstrate and classify pars fracture line as same as CT is still controversial. This meta-analysis aimed to determine sensitivity and specificity of MRI in the direct visualisation of the pars defect. The PubMed and Embase databases were systematically searched for relevant studies from the earliest researchable time to December 2016 for cases in which the accuracy of MRI was reported for the diagnosis of spondylolysis in young patients. Two reviewers independently assessed the methodological quality for each selected study using the quality assessment of diagnostic accuracy studies 2 tool. A meta-analysis of the reported sensitivity and specificity of pooled data of selected studies was performed by a systematic review. For each selected study, sensitivity and specificity was recalculated, by considering only direct visualisation of a fracture line of the pars. The hierarchic summary receiver operating characteristic curve was generated to estimate the diagnostic performance of MR imaging. Heterogeneity was also tested. The systematic review identified 4 out of a total of 1300 studies to be included in the meta-analysis. On a per-pars basis (a total of 1122 pars), the pooled sensitivity and specificity of the MRI for the direct diagnosis of a pars defect were 81% (95% CI 54–94%) and 99% (95% CI 98–100%), respectively. A high overall heterogeneity (I2 = 79.5%) was computed with respective high and low heterogeneity on sensitivity (I2 = 87.9%) and specificity (I2 = 38.4%). This meta-analysis demonstrated a high diagnostic performance of MR imaging for the diagnosis of a pars defect in young adults. This technique may be considered as a first-line imaging technique as it helps to avoid exposure to ionising radiation.

Successful usability evaluation of interactive adaptive systems requires the use of appropriate methods. Different usability evaluation methods exist in the literature. These methods can be applied in association with the individual layers and with the whole adaptive system. In each situation, it is essential to apply the appropriate evaluation methods. In this paper, we propose a novel decision support approach called EvalCHOICE. It guides evaluators in the choice of appropriate usability evaluation methods for individual layers and the adaptive system as a whole. Our proposal is applied to determine the suitable evaluation methods for a given Web-based adaptive system in the field of transport.

Background This study aimed to describe the spectrum of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to investigate its bacterial etiology. Methods Sixty-five consecutive cases of PSAHO admitted to our institution over a 16-year period (2000–2015) were retrospectively reviewed to assess their laboratory and radiographic imaging features, as well as their bacteriological etiology. Results On evaluation, white blood cell count and C-reactive protein were normal in 53 (81.5 %) and 34 cases (52.3 %), respectively, whereas the erythrocyte sedimentation rate was superior to 20 mm/h in 44 cases (72.1 %). Blood cultures failed to identify the pathogen in all but one patient, and classic bone sample cultures only managed to isolate the pathogen in five cases (11.6 %). Use of polymerase chain reaction (PCR) assays on bone aspirates or blood allowed the causative microorganism to be isolated in a further 22 cases. Using classic cultures and PCR assays together resulted in pathogen detection in 27 cases (62.8 % of the children bacteriologically investigated), with Kingella kingae being the most frequently reported microorganism. Conclusions Two distinct forms of PSAHO should be distinguished on the basis of age of patients and bacteriological etiology. The infantile form affects children aged between 6 months and 4 years and is predominantly due to K. kingae. The juvenile form involves children aged >4 years and Staphylococcus aureus appears to be the main bacteriological etiology. Appropriate nucleic amplification assays drastically improve the detection rate of the microorganisms responsible for PSAHO. Level of evidence: Case series, level IV.

Part 5: Usability Evaluation and UI Testing; International audience; Choosing the appropriate usability evaluation methods is a key part of the usability evaluation process of interactive adaptive systems. This step needs the consideration of different factors, leading to a multi-criteria decision analysis problem. In this paper, we present a review of the main factors reported in the literature which can affect the selection of usability evaluation methods for interactive adaptive systems. Three of the most commonly used usability evaluation methods are selected and classified according to these factors. The results of this research are used by applying a decision aid method in order to guide the choice of suitable usability evaluation methods for a given adaptive system in the field of tourism.

Background: Acoustic radiation force impulse imaging (ARFI) is a recent ultrasound technique to assess tissue stiffness. Objective: Our aim was to describe the feasibility and to define normal ARFI values in liver in children. Materials and methods: ARFI values were measured in 103 children (ages 2weeks to 17years) divided into four age groups, at a minimum depth of 3cm. In 20 children, measurements were done at 3-, 4- and 5-cm depth in the liver to assess the suitability of measurement location. The impact of age groups and of depth groups was examined using multilevel models. The precision of the measurements was determined using intraclass correlation coefficient (ICC). Results: There was no statistical difference between measurements taken at different ages, with a mean propagation velocity of 1.12m/s (range: 0.73 to 1.45m/s). There was no significant difference according to the depth of the regions of interest (up to 5cm). The ICC was 0.77 (95% CI 0.69-0.83). Conclusion: ARFI is feasible in children at any age with an acceptable reliability. The depth of measurements in the liver seems to have no influence on test results. We set the standard ARFI elastography values for healthy liver in children

Although rare, inflammatory myofibroblastic tumor is the most common primary lung mass in children. We report the case of an 11-year-old boy investigated for persistent cough and dyspnea with complete left lung atelectasis mimicking pneumonia. CT and MRI showed an endobronchial mass of the left main bronchus. The boy underwent endoscopic resection of the tumor and histology was in favor of an inflammatory myofibroblastic tumor of the lung. This diagnosis should be suspected in children with recurrent pneumonia. The prognosis is good after complete resection.

Purpose The aim of the present investigation was to evaluate, in patients with juvenile idiopathic arthritis, the effect of lavage with or without intra-articular corticosteroid (IACS) injection on clinical temporomandibular joint (TMJ) signs and symptoms of inflammation and changes in acute inflammation as assessed using magnetic resonance imaging (MRI). Materials and Methods Forty-one patients (mean age, 13.6 ± 4.0 yr) with juvenile idiopathic arthritis participating in a large prospective juvenile inflammatory rheumatism cohort study (JIRcohorte) were included in this study. Clinical history, examination, and MRI were carried out at baseline and 6 months after intervention, if any. Twenty-one patients underwent lavage and IACS injection in at least 1 TMJ, 8 patients underwent lavage of at least 1 TMJ, and 12 patients were followed with no intervention. Outcomes measured were maximal mouth opening, Helkimo dysfunction index scores, pain intensity, and acute inflammation as assessed using MRI. Results All groups showed a mean increase in mouth opening and mean decrease in pain intensity. The mean Helkimo clinical dysfunction score decreased for the 2 intervention groups but not for the control group. The mean Helkimo anamnestic dysfunction score decreased for the lavage with IACS group but not for the lavage-only group. The only statistically relevant difference was found for the Helkimo anamnestic dysfunction score comparing the lavage-only with the lavage with IACS group, with a more positive effect found in the lavage with IACS group. More than 50% of joints in each group showed no change at MRI examination. Joints with lavage and ICAS injection showed better improvement than joints that had lavage only or no intervention. Conclusion TMJ lavage with or without IACS injection cannot be claimed to systematically decrease pain, increase mouth opening, or resolve acute inflammation. Despite a tendency for improvement, response to this treatment is very patient dependent and can be determined by an array of other variables.

Case We report the case of an 11-year-old girl who developed osteonecrosis of the femoral head in the radiographically normal, asymptomatic left hip that had been fixed prophylactically in the context of a slipped capital femoral epiphysis (SCFE) that had been detected on the contralateral hip. The etiology of the osteonecrosis remains unknown. Conclusion This case report demonstrates that prophylactic fixation of a radiographically normal, asymptomatic hip in the context of an SCFE on the contralateral side has the potential for substantial complications. Therefore, the risk of osteonecrosis in the prophylactically pinned hip should be carefully considered because this complication may have devastating functional consequences.

Many usability evaluation methods for interactive adaptive systems exist in the literature. There is not yet an agreement in the adaptive system community about which method is more useful than another in specific evaluation situations. This raises the question, “What is (are) the best evaluation method(s) that need(s) to be used in specific evaluation constraints?” This paper presents possible directions to address this issue by proposing a multi-criteria decision support framework for selecting the appropriate evaluation methods for interactive adaptive systems. The proposed decision support framework is applied to determine the suitable usability evaluation methods for a specific adaptation layer of a given adaptive hypermedia system.

Isolated osteomyelitis of the patella is a rare condition mainly occurring in the pediatric population. Diagnosis is often delayed as clinical presentation manifests with vague anterior knee pain, sometimes with mild local signs of inflammation but frequently without any local signs at all. While falls on the knee can explain mild knee pain, erythema, swelling and persistent peripatellar pain should raise a high index of suspicion for local infection. We present two cases of subacute osteomyelitis of the patella in young children. In both cases bone lesions presented as an osteolytic lesion of the patella. After open biopsy of the lesion, bacteriological analysis confirmed infection with Kingella kingae.

International audience; The layered evaluation of interactive adaptive systems has to consider many evaluation methods. The best evaluation method to be used for individual layers depend on many parameters such as the evaluation criteria, the stage of the development cycle, and the characteristics of the layer under consideration. This paper presents a decision model for selecting the appropriate evaluation methods for individual layers of the interactive adaptive system. Our proposal is based on one multi-criteria method, namely ELECTRE TRI method. The proposed decision model is applied to determine the suitable evaluation methods for an adaptive hypermedia system.

International audience

This study aimed to predict the modification of the alignment between the tibial tubercle (TT) and the trochlear groove (TG) that occurs during femoral or tibial hemiepiphysiodesis. MRI scans of 541 knees were retrospectively reviewed to determine the distances between the cranial insertion of the patellar tendon on the TT and the femoral physis (FP)/tibial physis (TP). Thereafter, we developed a trigonometric formula to calculate the predicted change of the TT-TG distance that occurs during hemiepiphysiodesis around the knee using both the planned angular correction as well as the length between the physis (both distal femoral and proximal tibial) and the insertion of the patellar tendon of the TT. This study showed that TT-FP and TT-TP distances vary very little with sex and age during growth and the mean values of FP-TT and TP-TT distances (55 and 7 mm, respectively) can thus be used in clinical settings for calculating a rough estimate of the translation of the TT position that will occur during 'guided growth'. On this subject, one can expect a 1 mm simultaneous lateral or medial transfer of the TT for every 1° of angular correction during distal femoral hemiepiphysiodesis. For proximal tibial hemiepiphysiodesis, an angular correction of 8° should roughly translate into a simultaneous 1 mm transfer of the TT. This study puts forward the hypothesis that a simultaneous modification of the TT-TG distance has to be expected following hemiepiphysiodesis, whether femoral or tibial. LEVEL OF EVIDENCE III.

Although genetic defects are the leading cause of central nervous system malformations including in the posterior fossa, specific malformative patterns should alert the clinician to consider rather a teratogenic etiology. We discuss the imaging features of 2 mid-hindbrain malformations consecutive to the intake of isotretinoin (Roaccuatane®; case 1) and misoprostol (Cytotec®; case 2) during pregnancy and review the pertinent literature. We correlate the morphological appearance of the mid-hindbrain malformation, as seen on high-resolution magnetic resonance imaging to possible drug-induced pathogenetical mechanisms. The recognition of characteristic imaging patterns enables diagnosis of and/or confirmation of suspected drug-induced hindbrain malformations. This has important medicolegal implications and also clinical significance to avoid unsuccessful and misleading genetic testing.

Introduction La spondylolyse est decrite comme une fracture de stress chez de jeunes patients. Le diagnostic est couramment effectue avec un scanner (CT) considere comme reference, ce qui represente une exposition significative aux irradiations sur une population generalement en croissance. Parallelement, le role de l’imagerie de resonance magnetique (IRM) pour identifier un œdeme/une inflammation sur un isthme vertebral comme lesion active est reconnu, mais sa capacite a identifier un trait de fracture comme le fait le CT est encore controversee. L’objectif de cette etude est d’effectuer une revue systematique de la litterature ainsi qu’une meta-analyse pour determiner la sensibilite et specificite de l’IRM dans le diagnostic de la spondylolyse sur une population de jeunes patients, en prenant en compte la visualisation directe de la lesion de l’isthme vertebral. Materiel et methodes Une revue systematique d’etudes evaluant la sensibilite et la specificite de l’IRM dans le diagnostique de la spondylolyse chez des jeunes patients a ete effectuee dans les bases de donnees Pubmed et Embase (jusqu’au 15 mars 2016). Deux investigateurs ont ensuite evalue independamment la qualite methodologique des etudes selectionnees avec l’outil Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2). Une meta-analyse a ete effectuee sur les sensibilites et specificites rapportees par les etudes selectionnees dans la revue systematique. Enfin, une courbe hierarchic summary receiver operating characteristic (HSROC) a ete generee pour estimer la precision diagnostique de l’IRM pour la spondylolyse, accompagnee de la mesure de l’heterogeneite entre les etudes selectionnees. Resultats A l’issue des etapes de selection de la revue systematique, quatre etudes sur les 1300 initialement identifiees ont ete selectionnees pour la meta-analyse. Sur la base d’une analyse par isthme vertebral (total de 1122 isthmes), les sensibilites et specificites globales de l’IRM dans le diagnostic des spondylolyses etaient respectivement 81 % (95 % IC : 54–94) et 99 % (95 % IC : 98–100). Une heterogeneite globale elevee (I2 = 79,5 %) a ete evaluee avec respectivement une heterogeneite elevee pour la sensibilite (I2 = 87,9 %) et faible pour la specificite (I2 = 38,4 %). Discussion Cette etude a montre que le diagnostic de la spondylolyse par IRM presente une sensibilite et une specificite elevees sur un total de 1122 isthmes vertebraux d’enfants et de jeunes adultes. L’IRM peut etre consideree comme outils diagnostic de premiere ligne et ainsi aider a reduire considerablement l’exposition aux rayonnements ionisants.

Objectives To evaluate the diagnostic accuracy of fetal cerebral magnetic resonance imaging (MRI) on a large cohort and to compare pre- and postnatal MRI data. Methods This prospective study included all cases referred to our unit for fetal cerebral MRI examination between June 2006 and December 2009 and which underwent at least one postnatal MRI examination. Cases in which there was termination of pregnancy, fetal death or stillbirth were excluded. The pre- and postnatal diagnoses established by MRI were compared and divided into five subgroups: same diagnosis on pre- and postnatal MRI (Group 1); same diagnosis but different appearance related to the natural course of the disease (Group 2); different diagnosis (related to limitations of fetal MRI) (Group 3); same diagnosis but with additional findings discovered on postnatal MRI examination (Group 4); or same diagnosis but different appearance related to the natural course of the disease (as in Group 2) and associated with additional findings discovered on postnatal MRI examination (Group 5). The prognostic impact of a possible disagreement between pre- and postnatal findings was evaluated. Results One hundred fetuses were included. Fetal MRI was performed at a mean gestational age of 33 (range, 24–39) weeks and postnatal MRI at a mean age of 3.5 months. There were 53 cases classified as Group 1, 32 in Group 2, four in Group 3, 10 in Group 4 and one in Group 5. Thus, in 15 cases (Groups 3–5), there were discrepancies between pre- and postnatal findings (mostly related to corpus callosum anatomy, cortical and migration disorders). The discrepancy was judged to have a prognostic impact in 9/15 cases. Two postnatal MRI examinations were performed in eight cases, in one of which the second examination showed subependymal heterotopia which were not detectable on the first examination. Conclusion Pre- and postnatal MRI data showed good agreement in 85% of cases. There was disagreement with a prognostic impact in 9% of cases. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

To assess the contemporary bacteriologic epidemiology of pediatric osteoarticular infection with particular regard to children's ages, because Kingella kingae has gained increasing recognition as the predominant pathogen for osteoarticular infection in young children.Retrospective file review of enrolled children from 0 to 15 years of age, admitted to our institution from 2007 to 2015 for suspected osteoarticular infection (217 cases). Information on age, sex, the bone or joint infected, imaging studies, and laboratory data (including bacterial investigations) were collected for analysis.Microorganism identification was possible for 138 infected children (63.6%), through blood (cultures or polymerase chain reaction [PCR]) and/or operative samples (cultures or PCR). Thirty-one patients (14.3%) were found to both have positive blood cultures and operative samples. The results of positive bacteriology specimens identified the most common causative pathogen for osteoarticular infection as K kingae (47.8% of microbiologically confirmed osteoarticular infections of all ages, and 87.7% in children between the ages of 6 and 48 months), significantly more common than Staphylococcus aureus (35.5% of microbiologically confirmed osteoarticular infections of all ages, and 78.2% in children4 years of age).Use of the appropriate PCR assays demonstrated that K kingae currently is the major bacterial cause of pediatric osteoarticular infection, especially in children4 years of age in whom K kingae is more common than S aureus. PCR assays should be used in routine microbiologic laboratory evaluation to improve diagnostic performance. However, despite the use of molecular methods, there are many osteoarticular infections in which no microorganism is detected, which suggests that these infections may be caused by other as yet unrecognized fastidious microorganisms.

Emerging strain of Stapylococcus aureus (S. aureus) producer of the Panton-Valentine Leukocidine (PVL+) are becoming a new issue in public health. Those bacteria are accountable for serious cutaneous infection with a necrotic evolution, necrotizing pneumonia and severe osteoarticular infection. These last infections can be life-threatening and are at high risk of complications. Therefore, a multidisciplinary approach is necessary, in addition with an aggressive chirurgical treatment. We are here reporting 3 cases of osteoarticular infections by S. aureus PVL+ sensitive to methicilline, which illustrate the difficulties encountered in the management and treatment, as well as the potential for serious orthopedics complications.

A 3-year-old boy being followed up for bilateral club foot underwent a routine thorax radiography that revealed aortic arch enlargement. Echocardiography showed sinus of Valsalva dilatation. Because of clinical features such as hypertelorism, bifid uvula, and prominent forehead, a genetic investigation was conducted that confirmed Loeys-Dietz syndrome (LDS) by identifying a heterozygous mutation in the gene encoding transforming growth factor-β receptor type 2 (TGFBR2). Whole-body magnetic resonance angiography was performed on a 1.5T machine. The magnetic resonance protocol included 3-dimensional contrast-enhanced angiographic sequences of the body and time-of-flight sequences of the brain. Whole-body magnetic resonance imaging demonstrated typical cardiovascular findings: Dilatation of the aorta at the level of sinus of Valsalva; tortuosity of the aortic arch, the 2 internal carotid arteries, the 2 vertebral arteries, and left subclavian artery; …

‘Sinus pericranii’ is an abnormal communication between the extracranial veins and the dural venous sinuses (usually the superior sagittal and the transverse sinuses). It is a rare childhood abnormality. We report a case of a 6-month-old boy presenting with a scalp swelling in the left parietal region. Ultrasound with color Doppler and MRI showed a dilated epicranial vein that communicated with the superior sagittal sinus. This anomalous venous connection is known as sinus pericranii. We describe the imaging findings, associated abnormalities and management of this rare vascular abnormality.